Irritable Bowel Syndrome (IBS)
1. PRELIMINARY DATA
- No.: 204/2026
- Patient's Name: MNO
- Address: Plot 22, Green Vista Society, Pune.
- Occupation: Accountant (high mental stress, sedentary lifestyle, irregular meals)
- Religion: Hindu
- Date: 15/03/2026
- Age: 45 Years
- Sex: Male
- Education: M.Com, CA
- Status: Married
2. CHIEF COMPLAINTS AND ASSOCIATED TROUBLES
| LOCATION | SENSATION & PATHOLOGY | A/F & MODALITIES | CONCOMITANTS |
|---|
| Abdomen (lower, umbilical & left iliac fossa) | Alternating constipation & diarrhoea, bloating, cramping pain relieved by stool | < After eating (especially spicy/oily), < Stress/anxiety, < Morning, > Passing stool/gas, > Warm drinks, since 7 years (worse last 3 years) | Flatulence offensive, incomplete evacuation sensation, mucus in stool occasionally |
| General GIT | Gurgling, rumbling in abdomen | < Cold food/drinks | Fatigue, irritability, low backache after stool |
3. PERSONAL PAST & FAMILY HISTORY
- Past History: Recurrent acidity in youth treated with antacids; suppressed skin allergy with steroids; frequent antibiotics for recurrent colds; overweight gain after marriage; stress from job promotions.
- Family History: Father has chronic constipation & piles. Mother has diabetes. Sister has anxiety disorder.
- Developmental Landmarks: All milestones were reached at the appropriate age.
4. PATIENT AS A PERSON (PHYSICAL CHARACTERISTICS)
A. Physical Characteristics
- Appetite: Variable, ravenous before attacks
- Desires: Sweets (+++), Spicy food (++), Warm drinks (+)
- Aversions: Milk, fatty food
- Thirst: Moderate, for warm fluids
- Elimination:
- Urine: Normal
- Stool: Alternating hard/loose, mucus sometimes
- Perspiration: Profuse on back & palms, sour
- Sleep: Disturbed by abdominal discomfort; wakes early with urge
- Thermal State: Chilly patient (cannot tolerate cold drinks or fan)
B. Reactions - Physical Factors
- Weather: Aggravation in cold damp weather
- Position: Better bending double during cramps
5. MENTAL STATE (Psychodynamic & Life-Space)
- Nature: Anxious, irritable, fastidious about work
- Anxiety: About finances, health (fear cancer), job security
- Fear: Fear of poverty, fear incurable disease
- Dreams: Falling, business failure, examinations
- Other: Suppressed anger, feels over-responsible
6. PHYSICAL GENERAL EXAMINATION
- Wt: 85 kg | Ht: 170 cm | Temp: 98.6°F
- RR: 18/min | Pulse: 84 bpm | B.P.: 138/86 mmHg
- Face: Tense, worried look
- Tongue: Coated white
- Nails: Normal
- Skin: Dry, occasional itching
7. SYSTEMIC EXAMINATION
- GIT: Abdomen distended, tympanic, mild tenderness in left iliac fossa, hyperactive bowel sounds
- CVS: S1, S2 Normal
- Respiratory: Clear
- Musculoskeletal: Mild lumbar stiffness
8. ANALYSIS AND EVALUATION OF SYMPTOMS
- Mental General: Anxiety about finances/health, fear poverty/disease, irritability (Grade 3)
- Physical General: Chilly, desire sweets/spicy, sour sweat, alternating bowel habit (Grade 3)
- Particular: IBS with bloating/cramping < stress/eating, > stool/gas/warm drinks (Grade 2)
9. SELECTION OF REPERTORY WITH REASON
- Repertory: Kent’s Repertory of Homoeopathic Materia Medica
- Reason: Chronic functional GIT disorder with prominent Mental Generals (anxiety, fears) and Physical Generals (thermal, desires, sweat) overriding particulars; Kent ideal for sycotic/psoric abdominal rubrics in IBS.
10. TOTALITY OF SYMPTOMS FOR REPERTORISATION
- Anxiety about finances and health
- Fear of poverty and incurable disease
- Desire sweets and spicy
- Chilly patient
- Profuse sour perspiration
- Alternating constipation/diarrhoea
- Bloating/cramping < stress/eating
-
Passing stool/gas
- Incomplete evacuation
- Mucus in stool
- Family GIT issues
11. CONVERSION INTO REPERTORIAL RUBRICS
| SR. NO. | SYMPTOMS | RUBRICS WITH SUB-RUBRICS | PAGE NO. (Kent) |
|---|
| 1 | Anxiety finances | Mind; ANXIETY; money matters, about | 8 |
| 2 | Fear poverty | Mind; FEAR; poverty, of | 46 |
| 3 | Desire sweets | Stomach; DESIRES; sweets | 486 |
| 4 | Abdomen pain cramping alternating stool | Abdomen; PAIN; cramping, griping; stool, amel | 574 |
| 5 | Stool mucus | Rectum; STOOL; mucous | 632 |
| 6 | Perspiration sour | Perspiration; ODOR; sour | 1298 |
| 7 | Chilly | Generalities; COLD; agg. | 1348 |
12. SELECTION OF REPERTORIZATION (NUMERICAL ORDER)
| SR. NO. | REMEDIES | RUBRICS COVERED | TOTAL MARKS |
|---|
| 1 | Nux Vomica | 7/7 | 21 |
| 2 | Lycopodium | 6/7 | 18 |
| 3 | Sulphur | 5/7 | 14 |
13. MIASMATIC INTERPRETATION
| PSORA | SYCOSIS | TUBERCULAR | SYPHILIS |
|---|
| Cramping, irritability, anxiety | Alternating bowel, mucus, bloating | Family stress-related issues | Destructive fear, suppression history |
Dominant Miasm: Psora-Sycotic
14. FINAL STEPS
- Provisional Diagnosis: Irritable Bowel Syndrome (IBS)
- Differentiation of Remedies: Compared Nux Vomica with Lycopodium. Lycopodium has more bloating > passing gas, right-sided, desire sweets but warm drinks; Nux Vomica matches stress-induced IBS, irritable/fastidious, chilly, desire spicy/sweets, incomplete evacuation, sour sweat, > warm drinks. Sulphur hot and untidy.
- Selection of Remedy (Materia Medica): Nux Vomica matches chronic IBS from overwork/stress, alternating stool, cramping < eating, irritability/anxiety, chilly, desire spicy/sweets, sour sweat (Ref: Allen’s Keynotes, Boericke).
- Selection of Potency: 200C (Chronic functional GIT case, sensitive constitution)
- Actual Prescription:
- Nux Vomica 200 — single dose (one dose only, wait & watch)
- Placebo — 4 pills twice a day for 6 weeks
15. FOLLOW-UP'S TABLE
| DATE | COMPLAINTS | REMEDY | ADVICE |
|---|
| 15/04/2026 | Bowel habit more regular, bloating reduced 60%, less cramping | Placebo | Regular meals, reduce spicy/oily, stress management (yoga) |
| 15/07/2026 | Alternating pattern gone, only occasional mild discomfort, energy improved | Placebo | Maintain fiber-rich diet, report stress triggers |